Your Guide For Total Hip Replacement Success

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Your Guide for Total HipReplacement SuccessAMITAhealth.org/Orthopedics

AMITA Health’s Evidence-based Orthopedics Practice is Supportedby the Following Clinical Practice Guidelines: AAOS Guideline on Preventing Venous Thromboembolic Disease inPatients Undergoing Elective Hip and Knee Arthroplasty. AmericanAcademy of Orthopaedic Surgeons. 2011. Clinical Practice Guidelines Surgical Site Infection Prevention.National Association of Orthopaedic Nurses. 2013. American Society for Pain Management Nursing Guidelines onMonitoring for Opiod-Induced Sedation and Respiratory Depression.Americian Society for Pain Management Nursing. 2011. Transforming Care at the Bedside. How to Guide: Reducing PatientInjuries from Falls. Institute for Healthcare Improvement. 2008.For All of Your Orthopedic Needs, Trust AMITA HealthAMITA Health Adventist Medical Center Bolingbrook500 Remington Blvd., Bolingbrook, IL 60440630.312.5000AMITA Health Adventist Medical Center GlenOaks701 Winthrop Ave., Glendale Heights, IL 60139630.545.8000AMITA Health Adventist Medical Center Hinsdale120 N Oak St., Hinsdale, IL 60521630.856.9000AMITA Health Adventist Medical Center La Grange5101 S. Willow Springs Rd., La Grange, IL 60525708.245.9000AMITA Health Alexian Brothers Medical Center Elk Grove Village800 Biesterfield Rd., Elk Grove Village, IL 60007847.437.5500AMITA Health St. Alexius Medical Center Hoffman Estates1555 Barrington Rd., Hoffman Estates, IL 60169847.843.2000AMITA Health Alexian Brothers Rehabilitation Hospital Elk Grove Village935 Beisner Rd., Elk Grove Village, IL 60007847.640.5600AMITAhealth.org/Orthopedics 2018 AMITA Health 180120

INTRODUCTIONContact NumbersTable of ContentsAMITA Health Adventist Medical CentersHinsdale and La GrangeScheduling Pre-surgical Joint Class855.MyAMITA (855.692.6482)IntroductionIntroduction Welcome Letter4What Is Total Hip Replacement?5Pre-surgical Tests630.856.7070Preparing for Surgery6Practice Good Nutrition7Central Scheduling630.856.7070Arranging for Care After Surgery8Preparing Your Home8Orthopedic Nurse Navigator708.245.BONE (2663)Equipment You May Need For Recovery 9Pre-surgery Exercises11Medication Options Post-surgicalPain Management13Day Before Surgery14Day of Surgery/Hospital Stay15Day of Surgery15Days After Surgery17Prepare for Discharge18The Zones of Total Hip Replacement19Preventing Post-surgical Complications 20AMITAhealth.org/OrthopedicsUsing Your Spirometer“Breathing Exerciser”21Mobility22Posterior Hip Precautions22Anterior Hip Precautions23Exercises After Surgery24Advanced Exercises After Surgery27Activities of Daily Living28Functional Mobility28Getting Into and Out of a Chair30Car Transfers31Tub/Shower Transfers32Bathing and Dressing33Frequently Asked Questions35Notes383

INTRODUCTIONIntroduction to Total Hip Replacement SuccessDear Patient,Thank you for choosing AMITA Health Orthopedics Institute for your total hip replacementsurgery. At AMITA Health, our healthcare team is focused on ensuring your stay with usis exceptional.We realize that being in the hospital may be an uneasy experience. Therefore, through ourvalues of God honoring, justice, compassion, integrity, and dignity we strive to make yourhospital stay as pleasant and comfortable as possible. These values drive our organizationto provide patient-centered care by actively partnering with our patients in their healthcare.Our mission is to extend the healing ministry of Jesus to the community by providing quality andcompassionate healthcare. We are devoted to responding to the needs of our patients and theirfamilies. Our staff is committed to providing you safe and efficient care in a professional andcourteous manner.This guidebook holds important instructions and information to help prepare you for yourjoint replacement, and it clearly outlines the things you need before, during and after yourprocedure. Please use the guidebook as a reference throughout your medical experience withus, as it includes pre- and post-surgical exercises and planning tools. Once again, thank you forchoosing AMITA Health for your orthopedic care.Sincerely,Your AMITA Health Orthopedics Institute Care TeamAcknowledgementsThank you to the AMITA Health Patient and Family Advisory Committee for their contributions indeveloping this patient-centered educational tool. The committee members are an invaluableresource of actual patients and family members. Their experiences and stories demonstrate bothexcellence and opportunities for improvement in the way healthcare is delivered at AMITA Health.4Your Guide for Total Hip Replacement Success

INTRODUCTIONWhat Is Total Hip Replacement?The hip is one of the body’s largest joints.It is a ball-and-socket joint. The socket isformed by the acetabulum, which is part ofthe large pelvis bone. The ball is the femoralhead, which is the upper end of the femur(thighbone). Cartilage lines and cushions thebones at this joint, but over time the cartilagecan wear away and bone rubs against bone,causing pain, stiffness, and difficulty withwalking. Hip replacement surgery is a safeand highly effective procedure that can relieveyour pain, increase motion, and help you getback to enjoying normal, everyday activities.Additional benefits may include correcting leglength or deformity.Explanation of the ImplantArtificial hip implants are made of metal,plastic, and sometimes ceramic components.The implant is secured to the bone by one oftwo methods. It is either press-fit or cementedinto place. In the press-fit method, the implantis fit snugly into the bone, and new bone formsaround the implant to secure it in position.When an implant is cemented, a specialbone cement is used to secure the implant inposition. The type of implant and method offixation will be determined by your surgeon.Your Hospital StayYou will be admitted to the hospital onthe day of your surgery and the surgicalprocedure will last approximately one totwo hours. Your care after surgery will includea one to three day comprehensive inpatientrehabilitation program. You will receivephysical and occupational therapyto ensure a successful Exercise strengthens the muscles supportingthe hip and maintains hip motion. Duringyour inpatient rehabilitation, members of ourphysical therapy team will instruct you onwalking, moving, sitting, standing and more aswell as engage you in an exercise program.A successful recovery requires your activeinvolvement in the rehabilitation phase for sixto twelve weeks after you go home, includingfollowing precautions after surgery, usingassistive equipment correctly and continuingto follow therapy instructions.5

PREPARING FOR SURGERYPreparing for Surgeryq DO NOT use a razor to shave the area ofsurgery for five days before your surgeryCongratulations! With your decision to have atotal hip replacement you have taken the firststep toward freedom from pain and discomfort.By following these guidelines and instructionsprovided by your physician, you will be wellprepared for your surgery. If you have additionalquestions, call an Orthopedic Nurse Resourcewhose number is listed on page 3.– Razors can cause small tears in theskin that can lead to infectionSafely Manage MedicationsSchedule Your Medical and DentalAppointmentsq Primary Care Physician: A full physicalexam is needed for surgical readiness (date) STOP: Discuss all of your currentmedications with your prescribingphysician(s). Certain medications, such asblood thinners, may need to be changedfor a period of time before surgery. Foryour reference, some common bloodthinning medications are listed below:q Dentist: An oral check-up to ensure thereare no potential sources of infection (date)q Pre-surgical Testing: To completenecessary bloodwork and tests for a safesurgery (date)ff Surgeon’s Office: Remember to completeany paperwork for time away from work wellbefore your surgery per your employer’sHuman Resources Department requirements (date) Anti-inflammatory– Aspirin– Celebrex– Ibuprofen (ex: Advil, Motrin)– Indocin– Naproxen (ex: Aleve)Blood Thinning– Coumadin– Eliquis– Plavix– Pradaxa– Xarelto– OthersVitamins and Herbals– Stop all prior to surgeryq Other as directed by physician(s): (date)Attend a Pre-surgical Joint Replacement Classq Day and evening classes are available.Numbers for scheduling a pre-surgical jointclass are listed on page 3.Prevent Infectionsq Take two showers before surgery,and wash with Hibiclens 1: night before surgery2: morning of surgeryRefer to page 14 for instructions.6Write Down Notes from Pre-surgicalTesting Call Stop eating and drinking the day beforesurgery at (time) Arrive day of surgery for registration andany additional testing that may be requiredat (time) Take the following medications the morningof surgery with ONLY a sip of water:Your Guide for Total Hip Replacement Success

PREPARING FOR SURGERYPractice Good NutritionPractice Good Nutrition Increase protein intake 14 days prior tosurgery to improve wound healing andmuscle strength– Good sources of protein include eggs,fish, meat, beans, dairy products, andprotein shakesWhat You Eat Helps Your Recovery!Good nutrition before surgery, during yourhospital stay and when you go home helps toimprove your recovery by: Ensure Active High Protein shake Glucerna Advance for those living withdiabetes to help control blood sugars Or equivalent supplement that provides12-16 grams of protein per servingTips for Adding Ensure Active High ProteinShake or Glucerna Advance to Your DailyRoutine Drink half of a bottle with vitamins ormedications instead of water or juice twoto three times a day Decreasing your risk of infection Serve chilled or freeze into a popsicle Helping you leave the hospital sooner Enjoy as a morning or afternoon snack Reducing the need to come back to thehospital once you are home Pour over cereal instead of milk; use as acreamer for coffee Add flavoring extract to change the flavors(for example, add mint to a chocolateshake)Helping you feel strongerThe Rule of 2’sPeople who drink TWO of the following perday TWO weeks prior to surgery, during theirhospital stay, and TWO weeks after surgeryheal better and faster!AMITAhealth.org/Orthopedics Visit EnsureHealthyMatters.com foradditional recipes and coupons7

PREPARING FOR SURGERYArranging for Care After SurgeryMost patients are able to go home after their surgery. This includes patients who live independently.In most cases, we believe your home is the best and safest location for your recovery. Manyfactors will be considered in this decision, including availability of family or friends to assistwith daily activities, home environment and safety considerations, post-surgical functional statusas evaluated by a physical therapist in the hospital and overall evaluation by your hospital team.If you are not safe to go home at the time of discharge, you may go to a rehabilitation facilityto gain the skills you need to safely return home. Your discharge planner will provide you withoptions and how they are impacted by your insurance carrier. Throughout your recovery, youwill work with your care team to make the right choice.Home with Home Health CareA majority of patients go home after surgerywith in-home therapy services. These patientstypically have better outcomes.Skilled Nursing FacilitiesSkilled nursing facilities provide nursing careand rehabilitation services for a short-termstay to prepare you for transition to home.Coverage: Medicare: Choice of any agencyCoverage: Medicare: Choice of any facility Medicare/Medicaid Replacement Plans/Other Insurance Plans: Insurancedetermines which home health agenciesare approved Medicare/Medicaid Replacement Plans:Insurance approves facility based onpatient meeting set criteriaTypical In-home Services: Physical/Occupational TherapyAcute Rehabilitation/Inpatient HospitalAcute Rehabilitation is only for patients withuncontrolled medical conditions that mayimpact rehabilitation. Joint replacementpatients rarely go to this type of facility. Nursing care (incision and medicationmonitoring)Outpatient Physical/OccupationalTherapy Services Facility that offers therapy duringbusiness hours Just like an in-home therapist, thesetherapists communicate with your surgeonabout your progressCoverage: Medicare: Choice of any facility; aphysiatrist MUST admit the patient Medicare/Medicaid Replacement Plans:Insurance approves facility based onpatient meeting specific criteriaPreparing Your Home Set up a bed on the 1st floor if necessary.8 Prepare meals ahead of time for the firstfew days after you return home. To reduce fall risks, clear your floor of suchthings as foot stools, electrical cords andeven small pets. Rearrange your kitchen to have thoseitems you need a lot at a reachable level. Take up scatter or throw rugs if you havethem on the floors.Your Guide for Total Hip Replacement Success

PREPARING FOR SURGERYEquipment You May Need For RecoveryThe following equipment may be neededfor your recovery. Your surgeon and therapyteam will instruct you on what is appropriatefor you. Make a list of equipment you will need to useafter surgery. Locate medical supply companies in yourcommunity. Ask any questions you might have aboutobtaining equipment. Some insurance plans require physicianauthorization.Obtaining Home Equipment: Small, personal equipment may bepurchased from the hospital or fromonline vendors Lending closets are an alternative tousing insurance to purchase equipment.More information about commonequipment can be found in the FrequentlyAsked Questions (FAQs) section at theend of this booklet. See page 35.Bathroom Equipmentq Grab BarsInstall grab bars in yourshower or tub for supportas you get in and outq Non-slip Bath MatUse a rubber backedbathroom mat to help keepthe floor dryAMITAhealth.org/Orthopedicsq Handheld ShowerInstall a handheldshowerhead for easierbathingq Shower or Bath ChairSit on a bath bench orshower chair while youbatheq Long-handled SpongeUse a long-handledsponge to washhard to reach areasq Commode or RaisedToilet SeatUse a commode chair orelevated toilet seat to raisethe height of your toilet9

PREPARING FOR SURGERYEquipment You May Need For RecoveryAdditional equipment that may be helpful to you during your recovery. Your occupationaltherapist will discuss with you what is appropriate.10q Reacher(s)q Sock Aidsq Straight Caneq Long-handled Shoe Hornq Walkerq Standard CrutchesYour Guide for Total Hip Replacement Success

PREPARING FOR SURGERYPre-surgery ExercisesStrong leg muscles are key to a successful recovery. The following exercises will help prepareyour leg muscles for the surgery. By performing these exercises ahead of time, you will have the“muscle memory” to perform them more successfully during your hospital stay. These exercisesmay be performed on a bed or on the floor, whichever is more comfortable for you.1. A nkle PumpsBend ankles up and down, alternating feet. Repeat 20 times. Perform at least 4sessions per day. This exercise can be done sitting or lying down.2. Quad SetsLie with a rolled towel or pillow under heel of surgical leg. Tighten the muscles on the top ofthe leg/thigh while trying to push knee toward the rolled towel or pillow. Hold for 5 seconds. Relax.Repeat 20 times. Perform 2 sessions per day.3. Heel SlidesBend surgical leg and pull heel toward buttocks. Return slowly to extended position,sliding heel along the bed. Repeat 20 times. Perform 2 sessions per day.AMITAhealth.org/Orthopedics11

PREPARING FOR SURGERYPre-surgery Exercises4. AbductionSlide surgical leg out to the side. Keep leg pointed toward ceiling. Gently bring leg backto midline. Repeat 20 times. Perform 2 sessions per day.5. Straight Leg RaiseBend unaffected leg. Raise surgical leg six toeight inches with knee straight. Exhale and tightenthigh muscles while raising leg. Return slowly tobed. Repeat 20 times. Perform 2 sessions per day.6. Bicep CurlSit up straight. Keep yourelbow close to your body andyour wrist straight. Bend yourarm, moving your hand upto your shoulder, then lowerslowly. Do a set with each arm.127. Tricep CurlSit, leaning forward from thewaist. Bend your elbow sothat your forearm is parallel tothe floor. Then straighten yourelbow as you extend yourarm behind you. Do a set witheach arm.6. Chair Push UpsSit in a sturdy chair witharmrests. With palms flat onthe armrests, press down tolift your buttocks from thechair. Hold for 3-5 seconds.Bend your elbows to slowlyease back down.Your Guide for Total Hip Replacement Success

PREPARING FOR SURGERYMedication OptionsPCA (Patient Control Analgesia): You controlthe administration of medication, dependingon your needs. When you are in pain, pressthe BLUE button and you will receive a dosethrough your IV. To provide a steady level ofpain relief, only you should push the button.For your safety, the pump has special featuresto limit the amount of medication you canreceive in an hour. The PCA will only beavailable for a short period of time, no morethan 24 hours.IV Push: If you are experiencing moderate tosevere pain between doses, let your care teammember know right away so your pain careplan can be adjusted. IV medication providesquick relief versus sustained pain control.Oral (by mouth): Oral pain medications providethe best relief when taken at set times. Theywill also be prescribed for use at homeduring recovery. It is important to be sure thatyour oral pain medication is effective prior todischarge. When your pain is controlled, youwill be more active.Side effects from pain medications can be:nausea, vomiting, itching, dry mouth, drowsinessand/or constipation. Anti-nausea medicationsalong with stool softeners will be ordered foryou to help with these side effects. Rememberthat it is important to increase your fluid andfiber intake even when you are at home.Post-surgical Pain Management Throughout your hospitalization, your careteam will frequently evaluate your painlevel because pain symptoms vary fromperson to person, and we want to ensureyour pain control is tailored to your needs. Some level of pain after surgery is to beexpected. Our goal at AMITA Health is for your painto be at a functional level so you are ableto tolerate activity and participate in yourrehabilitation. With less pain you can startwalking, perform deep breathing exercises,regain strength more quickly, and minimizepotential complications such as pneumoniaand blood e6789Severe10 Ice is very important in managing your pain.Ice should only be applied 20 minuteson and 20 minutes off with your surgicalleg elevated. Ice packs should be usedthroughout the day and night along withpain medications. Remember it’s easy to stay on top of yourpain, but hard to catch up. Keeping a goodschedule to control the pain is key. TIP: You may want to set an alarm formiddle of the night medication doses.13

PREPARING FOR SURGERYDay Before SurgeryPre-surgery Bathing InstructionsPlease follow these instructions for showeringthe night before surgery. Hibiclens soap isordered to decrease bacteria on your skin.The instructions are VERY specific and need tobe followed exactly as written. Your leg will bewashed again thoroughly with a disinfectantat the hospital the morning of surgery.Instructions: Shower with Hibiclens (chlorhexidine)soap or, if you are allergic to chlorhexidine,use Dial liquid antibacterial soap the nightbefore your surgery.Packing Your Bag Before Your Hospital StayWhat to bring to the hospital: This educational booklet Photo identification and insurance card(no valuables) Three changes of comfortable clothing andslightly oversized walking shoes, due toswelling, for therapy Your CPAP or BiPAP machine with allnecessary accessories You will be able to use your cell phone inthe hospital Do not shave any area of your body. Power of Attorney and Advanced Directives Wash your hair as usual with your normalshampoo. Blood type wristband Rinse your hair and body thoroughly afteryou shampoo to remove all shampooresidue. If currently using supportive equipment,such as a brace or orthotic, bring to hospital Apply the Hibiclens (chlorhexidine) soapto your body, ONLY FROM THE NECKDOWN. Do not use this soap near youreyes or ears to avoid permanent injury tothose areas.What NOT to Bring to the Hospital:Do not bring a wallet ( just your photo ID andinsurance card), money, or any other valuables.Please remove all jewelry (including weddingband and piercings) and leave it at home. Youwill need money for your discharge medications,but please have a family member bring this tothe hospital after your surgery. If you have awalker at home, do not bring it to the hospital.One will be available for your use during yourhospital stay. Wash thoroughly, paying special attentionto the area where your surgery will beperformed. Turn water off while you wash to preventrinsing the soap off too soon. Wash your body gently for 5 minutes. DoNOT scrub the skin too hard. Do not wash with regular soap afterHibiclens (chlorhexidine) soap is used. Turn the water back on and rinse your bodythoroughly. Pat your body dry with a clean, soft towel. Do NOT use lotion, cream or powder. A list of your current medications MedicationsYou should NOT bring your medications tothe hospital. The only exception is if youuse a prescription eye drop or an inhaler.You have provided the hospital with acomplete list of your medications, andthese will be provided as necessary by thehospital during your stay. Change your bed linens the night beforesurgery. Wear clean clothing to bed.14Your Guide for Total Hip Replacement Success

PREPARING FOR SURGERYDay Before SurgeryDo Not Eat or Drink Anything After Midnightthe Night Before Your SurgeryThe night before your surgery, you should nothave anything to eat or drink after the time youwere instructed. If there are medications youare required to take the morning of surgery,please do so with only the smallest amount ofwater possible. If you are diabetic, check with your primarycare physician about how to adjust yourdiabetes medication.DAY OF SURGERY/HOSPITAL STAYDay of SurgeryWhat Happens the Day of Surgery?When you check in the day of your surgery,you will be asked to put a gown on and yournurses will check your health status.orthopedic unit, and the monitoring continueswhen you get to your room. We will get youup and moving sometime in the afternoon orevening, starting you on your road to recovery.If you wear nail polish or artificial nails, thesemay be removed when you arrive for surgery.After your surgery, you will be admitted to theorthopedic unit. Please review today’s goalsand expectations for your hospital recovery.If you wear contact lenses or dentures, you willbe asked to remove them before surgery.You will talk with an anesthesiologist who willmanage your health during the procedure. Theanesthesiologist will discuss medications andpain management options with you. You willhave an IV started and be given an antibioticbefore the surgery.When you leave for surgery, your family andfriends may wait in our waiting room andreceive communication from the surgical areaabout your status.Although your surgery will take between oneand two hours, you will be in the recovery areafor at least another hour. We will be checkingyour vital signs frequently before you go to theAMITAhealth.org/OrthopedicsYour care team will introduce themselves oftenand ask you to do the same.Hip Safety and TipsAfter surgery, your surgeon may prescribelimitations on certain movements (HipPrecautions) in order to decrease the risk ofa dislocation. These precautions will be basedupon your surgeon’s preferences or whichtype of approach you had for your surgery(Anterior vs Posterior, etc). Please see pages 22and 23 of this guidebook for a list of commonhip precautions. Your surgeon may modifythese instructions based on your specific needs.Ice Therapy is important for all surgicalpatients. Keep ice on your hip – 20 minuteson and 20 minutes off.15

DAY OF SURGERY/HOSPITAL STAYDay of SurgeryDay of Surgery AgendaMeet Your Care Team: Nurse, Patient CareTechnician and Physical Therapistq They will frequently monitor vital signs,pain, surgical dressings and circulation.q They will assist with personal care,however you are encouraged to be asindependent as possible.q Self-care is part of your daily therapy andone of your recovery goals.Partner for Mobility (only with assistance)This promotes blood flow and builds strength.q Goal 1: Sit at edge of bed within five hoursof surgery – for safety, two team memberswill help you.q Goal 2: Get out of bed and stand up.Start taking steps with assistance using arolling walker.q Goal 3: Transition to bedside chair, spendingtolerable amounts of time out of bed.Partner to Prevent Falls ALWAYS ask for help when getting up frombed or the chair – your safety is our mainconcern.Start with a Liquid Dietq Order tomorrow’s breakfast by 6:30 pmtoday, and request tray delivery no laterthan 8 am.q You will advance your meals to solid foodwhen you can tolerate it without feelingnauseated.q Continue taking a protein supplement tohelp with recovery.Use your Incentive Spirometer (BreathingExerciser) Practice 10 times every hour while awake.More information about how to use yourincentive spirometer can be found on page 21. Try to rest. Today was busy andtomorrow will be busier.Tomorrow’s Agenda Vital signs Morning lab work Transition to chair for breakfast andpersonal care Catheter removed if not already done Physical and Occupational Therapy Some medications can affect balance. Physician and surgeon visits Wear a gait belt. Discuss transition from intravenous (IV)to oral pain medication with nurse Follow the Fall Prevention Agreement thatwas reviewed when you were admitted. Bed and chair alarms are used to improveyour safety. Discuss discharge transition planwith care team Wear your nonskid socks at all times.Partner for Pain Management Discuss the pain scale with your care teamand set tolerable pain expectations. The goal of pain management is to focuson a level of pain that allows participationin daily activity. Remember! Some pain and discomfort isnormal after a total hip replacement.16Your Guide for Total Hip Replacement Success

DAY OF SURGERY/HOSPITAL STAYDays After SurgeryToday will be busy. We will introduce newexercises during rehabilitation, but don’t worry.We will go over everything many times. If youhave questions, ask us. We want your recoveryto be successful.It is normal to feel a bit more pain anddiscomfort today. Please inform your careteam of your pain level so we can work withyou to control the pain with ice and medicationas needed.Hip Safety and TipsReview your hip precautions and considerthem often throughout your hospital stayand when at home.Keep ice on your hip – 20 minutes onand 20 minutes off.Prepare for Your Dayq Vital signs and labs will be done early soyour doctors can review the results beforethey visit with you.q Get up, get out of bed and wash up.Continue Using the Incentive Spirometer –“Breathing Exerciser”q 10 deep inhales every hour while awake.For more information, please see page 21.Speak Up and Partner in Pain Managementq Continue or transition to oral painmedication as it provides longer pain relief.Keep Movingq Physical and Occupational Therapy.q Walk as far as you feel you can but ONLYwith assistance. A physical therapist will teach you how togo up and down stairs after surgery.You are the driver in your therapyq Remember: perform ankle pumps and wearcompression sleeves to prevent bloodclots from forming.Many patients will be ready to go home theday after surgery. This will depend on yourindividual progress.q Urinary catheter will be removed today,if not already removed.Eat Breakfast and Drink Plenty of Fluidsq Your diet will advance to more solid foodsas you tolerate without feeling nauseated.q Intravenous (IV) fluids may be discontinuedwhen you can tolerate food and fluids.q Continue protein supplement to helpwith recovery.AMITAhealth.org/Orthopedics17

DAY OF SURGERY/HOSPITAL STAYPrepare for DischargePrepare for Dischargeq Follow-up with your care team fordischarge transition plan and homeequipment needs. Keep track of theequipment you need on page 9.q You may be discharged today or tomorrow.Day of Dischargeq Our goal is to have you discharged fromthe hospital by early afternoon.q Review your discharge instructions andfollow-up guidelines to learn:– When to follow-up with surgeon– Incision site care and signs to watch forq Ensure home equipment is orderedSee list of equipment on page 35.q Review prescriptions and medicationside effects.Daily Tasks When You Get Homeq Take pain medications as needed andas directed.q Keep exercising.q Rest, ice and change position frequently.q Continue protein supplementsfor recovery.q No driving while taking pain medications.18Your Guide for Total Hip Replacement Success

DAY OF SURGERY/HOSPITAL STAYThe Zones of Total Hip ReplacementGreenZoneYou Should Be Feeling/Experiencing: No increased redness, warmness,swelling, drainage or odor at theincision site Dressing is clean and dry Pain is under control Eating well and drinkingadequate amount of waterand continuing to take proteinsupplement Restful night sleepYou Are On the Right Track if You: Keep your appointments with yourphysicians Take all medications as prescribed Change dressing as instructed Have bowel movements Balance exercises and rest periods Avoid lifting more than 10 lbs Follow your surgeon’s instructionsabout your hip precautions Ask for help when needed Therapy and exercises aredone dailyYellowZoneIf You’re

Posterior Hip Precautions 22 Anterior Hip Precautions 23 Exercises After Surgery 24 Advanced Exercises After Surgery 27 Activities of Daily Living 28 Functional Mobility 28 Getting Into and Out of a Chair 30 Car Tra

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